Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DESYRAE ELIZA RIDENOUR
ActiveDESYRAE ELIZA RIDENOUR is a Physician Assistant healthcare provider located in SPRINGFIELD, Missouri. NPI 1891557575 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SPRINGFIELD, MO
Registration Details
- NPI Number
- 1891557575
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 29, 2024 (2.5599282379424 yrs)
- Last Updated
- Apr 30, 2024
- License
-
2024003095 (MO)
Practice Information
- Address
-
960 E WALNUT LAWN ST STE 201SPRINGFIELD, MO, 658077865Browse MO providers · Browse ZIP 65807
- Phone
- 4172694450
- Fax
- 4172694470
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in SPRINGFIELD, MO
| Name | Credential | NPI |
|---|---|---|
| MS. JODY L STANTON | PAC, ATC | 1780684753 |
| MRS. KATHLEEN DAWN SMITH | PA | 1306833702 |
| MRS. LAURA CATHERINE ROSS | PA | 1689665218 |
| AMBER D HERRING | P.A.-C. | 1679555346 |
| MS. STEPHANIE LEA FOX | PA | 1487617742 |
| JODIE A. TUCKER | P.A. | 1972555712 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.